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Texas rates for HCPCS A4355

Irrigation tubing set for continuous bladder irrigation through a three-way indwelling Foley catheter, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.22 / $8.07 / $9.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.22 / $8.18 / $10.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.96 / $13.78 / $34.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.66 / $6.66 / $6.66
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $8.00 / $12.46
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.46 / $12.46 / $12.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.85 / $5.85 / $6.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.97 / $5.08 / $5.85
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.68 / $61.68 / $93.45
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.41 / $9.35 / $12.46
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.21 / $11.21 / $12.46
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.41 / $8.91 / $12.46
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.97 / $5.08 / $8.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.37 / $5.74 / $7.57
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.35 / $5.35 / $12.46